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Erschienen in: Acta Diabetologica 10/2018

22.06.2018 | Original Article

The effects of probiotics and synbiotic supplementation on glucose and insulin metabolism in adults with prediabetes: a double-blind randomized clinical trial

verfasst von: Nazila Kassaian, Awat Feizi, Ashraf Aminorroaya, Parvaneh Jafari, Maryam Tajabadi Ebrahimi, Masoud Amini

Erschienen in: Acta Diabetologica | Ausgabe 10/2018

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Abstract

Aims

Probiotics and/or prebiotics could be a promising approach to improve metabolic disorders by favorably modifying the gut microbial composition.

Objectives

To assess the effects of probiotics and synbiotic on glycemic indices in prediabetic individuals who are at risk of type 2 diabetes and its complications.

Methods

In a double-blind, randomized, placebo-controlled parallel-group clinical trial, 120 prediabetic adults participated and were randomly allocated to receive either probiotics or synbiotic or placebo supplements for 24 weeks. Anthropometric measurements, food record, physical activity and glycemic biomarkers including glycated hemoglobin (HbA1C), fasting plasma glucose (FPG), fasting insulin levels (FIL), homoeostasis model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and β-cell function (HOMA-B) were assessed at baseline and repeated at 12 and 24 weeks and compared within and between three groups using repeated measure ANOVA.

Results

Compared with the placebo, synbiotic supplementation resulted in a higher significant reduction in FPG (− 6.5 ± 1.6 vs. − 0.82 ± 1.7 mg/dL, P = 0.01), FIL (− 2.6 ± 0.9 vs. − 0.8 ± 0.8 µIU/mL, P = 0.028), and HOMA-IR (− 0.86 ± 0.3 vs. − 0.16 ± 0.25, P = 0.007), and a significant elevation in the QUICKI (+ 0.01 ± 0.003 vs. + 0.003 ± 0.002, P = 0.006). In addition, significant decreases in HbA1C was seen following the supplementation of probiotics and synbiotic compared with the placebo (− 0.12 ± 0.06 and − 0.14 ± 0.05 vs. +0.07 ± 0.06%, P = 0.005 and 0.008, respectively). HOMA-B was not found to be different between or within the three groups.

Conclusion

Glycemic improvement by probiotics and particularly synbiotic supplements in prediabetic individuals has been supported by current study. However, further studies are required for optimal recommendations in this important area of patient treatment.

Trial registration

Iranian Registry of Clinical Trials: IRCT201511032321N2, Date registered February 27, 2016.
Literatur
1.
Zurück zum Zitat Rokana N, Duary RK, Panwar H, Batish VK, Grover S (2012) Management of metabolic syndrome through probiotic and prebiotic interventions. Indian J Endocrinol Metab 16(1):20–27CrossRefPubMedPubMedCentral Rokana N, Duary RK, Panwar H, Batish VK, Grover S (2012) Management of metabolic syndrome through probiotic and prebiotic interventions. Indian J Endocrinol Metab 16(1):20–27CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Daniele G, Abdul-Ghani M, DeFronzo RA (2014) What are the pharmacotherapy options for treating prediabetes? Expert Opin Pharmacother 15(14):2003–2018CrossRefPubMed Daniele G, Abdul-Ghani M, DeFronzo RA (2014) What are the pharmacotherapy options for treating prediabetes? Expert Opin Pharmacother 15(14):2003–2018CrossRefPubMed
5.
Zurück zum Zitat Sato J, Kanazawa A, Watada H (2017) Type 2 diabetes and bacteremia. Ann Nutr Metab 71(Suppl 1):17–22CrossRefPubMed Sato J, Kanazawa A, Watada H (2017) Type 2 diabetes and bacteremia. Ann Nutr Metab 71(Suppl 1):17–22CrossRefPubMed
7.
Zurück zum Zitat Hulston CJ, Churnside AA, Venables MC (2015) Probiotic supplementation prevents high-fat, overfeeding-induced insulin resistance in human subjects. Br J Nutr 113(4):596–602CrossRefPubMedPubMedCentral Hulston CJ, Churnside AA, Venables MC (2015) Probiotic supplementation prevents high-fat, overfeeding-induced insulin resistance in human subjects. Br J Nutr 113(4):596–602CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Sáez-Lara MJ, Robles-Sanchez C, Ruiz-Ojeda FJ, Plaza-Diaz J, Gil A (2016) Effects of probiotics and synbiotics on obesity, insulin resistance syndrome, type 2 diabetes and non-alcoholic fatty liver disease: a review of human clinical trials. Int J Mol Sci 17(6):928CrossRefPubMedCentral Sáez-Lara MJ, Robles-Sanchez C, Ruiz-Ojeda FJ, Plaza-Diaz J, Gil A (2016) Effects of probiotics and synbiotics on obesity, insulin resistance syndrome, type 2 diabetes and non-alcoholic fatty liver disease: a review of human clinical trials. Int J Mol Sci 17(6):928CrossRefPubMedCentral
9.
Zurück zum Zitat Louis P, Flint HJ, Michel C (2016) How to manipulate the microbiota: prebiotics. Adv Exp Med Biol 902:119–142CrossRefPubMed Louis P, Flint HJ, Michel C (2016) How to manipulate the microbiota: prebiotics. Adv Exp Med Biol 902:119–142CrossRefPubMed
10.
Zurück zum Zitat de Vrese M, Schrezenmeir J (2008) Probiotics, prebiotics, and synbiotics. Adv Biochem Eng Biotechnol 111:1–66PubMed de Vrese M, Schrezenmeir J (2008) Probiotics, prebiotics, and synbiotics. Adv Biochem Eng Biotechnol 111:1–66PubMed
11.
Zurück zum Zitat Marchesi JR, Adams DH, Fava F, Hermes GD, Hirschfield GM, Hold G et al (2016) The gut microbiota and host health: a new clinical frontier. Gut 65(2):330–339CrossRefPubMed Marchesi JR, Adams DH, Fava F, Hermes GD, Hirschfield GM, Hold G et al (2016) The gut microbiota and host health: a new clinical frontier. Gut 65(2):330–339CrossRefPubMed
12.
Zurück zum Zitat Guiné RPF, Silva ACF (2017) Probiotics, Prebiotics and synbiotics. In: Nelson DL (ed) Functional foods: sources, health effects and future perspectives. Chapter 5. Nova Publishers, New York, 143–207 Guiné RPF, Silva ACF (2017) Probiotics, Prebiotics and synbiotics. In: Nelson DL (ed) Functional foods: sources, health effects and future perspectives. Chapter 5. Nova Publishers, New York, 143–207
13.
Zurück zum Zitat Poppitt S (2017) Hyperglycaemia, pre-diabetes and diabesity: can we choose who to ‘fast-track’into diabetes prevention? Curr Res Diabetes Obes J 2(3):1–3 Poppitt S (2017) Hyperglycaemia, pre-diabetes and diabesity: can we choose who to ‘fast-track’into diabetes prevention? Curr Res Diabetes Obes J 2(3):1–3
14.
Zurück zum Zitat Pandis N, Chung B, Scherrer R, Elbourne D, Altman D (2017) CONSORT extension for reporting within-person randomised trials. BMJ 357:1–22 Pandis N, Chung B, Scherrer R, Elbourne D, Altman D (2017) CONSORT extension for reporting within-person randomised trials. BMJ 357:1–22
15.
Zurück zum Zitat Eslamparast T, Zamani F, Hekmatdoost A, Sharafkhah M, Eghtesad S, Malekzadeh R et al (2014) Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: a randomised, double-blind, placebo-controlled pilot study. Br J Nutr 112(3):438–445CrossRefPubMed Eslamparast T, Zamani F, Hekmatdoost A, Sharafkhah M, Eghtesad S, Malekzadeh R et al (2014) Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: a randomised, double-blind, placebo-controlled pilot study. Br J Nutr 112(3):438–445CrossRefPubMed
16.
Zurück zum Zitat Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419CrossRefPubMed Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419CrossRefPubMed
17.
Zurück zum Zitat Hřebíček J, Janout V, Malinčíková J, Horáková D, Čížek L (2002) Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. J Clin Endocrinol Metab 87(1):144CrossRefPubMed Hřebíček J, Janout V, Malinčíková J, Horáková D, Čížek L (2002) Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. J Clin Endocrinol Metab 87(1):144CrossRefPubMed
18.
Zurück zum Zitat Mossavar-Rahmani Y (2017) Reducing measurement error in nutrition assessment: potential research implications for Iran. Nutr Food Sci Res 4(1):3–10CrossRef Mossavar-Rahmani Y (2017) Reducing measurement error in nutrition assessment: potential research implications for Iran. Nutr Food Sci Res 4(1):3–10CrossRef
19.
Zurück zum Zitat Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA et al (2013) Guide to the assessment of physical activity: clinical and research applications. Circulation 128(20):2259–2279CrossRefPubMed Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA et al (2013) Guide to the assessment of physical activity: clinical and research applications. Circulation 128(20):2259–2279CrossRefPubMed
20.
Zurück zum Zitat Yao K, Zeng L, He Q, Wang W, Lei J, Zou X (2017) Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit 23:3044–3053CrossRefPubMedPubMedCentral Yao K, Zeng L, He Q, Wang W, Lei J, Zou X (2017) Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit 23:3044–3053CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Festi D, Schiumerini R, Eusebi LH, Marasco G, Taddia M, Colecchia A (2014) Gut microbiota and metabolic syndrome. World J Gastroenterol WJG 20(43):16079CrossRefPubMed Festi D, Schiumerini R, Eusebi LH, Marasco G, Taddia M, Colecchia A (2014) Gut microbiota and metabolic syndrome. World J Gastroenterol WJG 20(43):16079CrossRefPubMed
22.
Zurück zum Zitat Abrams SA, Griffin IJ, Hawthorne KM, Ellis KJ (2007) Effect of prebiotic supplementation and calcium intake on body mass index. J Pediatr 151(3):293–298CrossRefPubMed Abrams SA, Griffin IJ, Hawthorne KM, Ellis KJ (2007) Effect of prebiotic supplementation and calcium intake on body mass index. J Pediatr 151(3):293–298CrossRefPubMed
23.
Zurück zum Zitat Pedersen C, Lefevre S, Peters V, Patterson M, Ghatei MA, Morgan LM et al (2013) Gut hormone release and appetite regulation in healthy non-obese participants following oligofructose intake. A dose-escalation study. Appetite 66:44–53CrossRefPubMed Pedersen C, Lefevre S, Peters V, Patterson M, Ghatei MA, Morgan LM et al (2013) Gut hormone release and appetite regulation in healthy non-obese participants following oligofructose intake. A dose-escalation study. Appetite 66:44–53CrossRefPubMed
24.
Zurück zum Zitat Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W et al (2007) Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 107(10):1755–1767CrossRefPubMed Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W et al (2007) Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 107(10):1755–1767CrossRefPubMed
25.
Zurück zum Zitat Taghizadeh M, Asemi Z (2014) Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial. Hormones 13(3):398–406PubMed Taghizadeh M, Asemi Z (2014) Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial. Hormones 13(3):398–406PubMed
26.
Zurück zum Zitat Tabrizi R, Moosazadeh M, Lankarani KB, Akbari M, Heydari ST, Kolahdooz F et al (2017) The effects of synbiotic supplementation on glucose metabolism and lipid profiles in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials. Probiot Antimicrob Proteins. https://doi.org/10.1007/s12602-017-9299-1 CrossRef Tabrizi R, Moosazadeh M, Lankarani KB, Akbari M, Heydari ST, Kolahdooz F et al (2017) The effects of synbiotic supplementation on glucose metabolism and lipid profiles in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials. Probiot Antimicrob Proteins. https://​doi.​org/​10.​1007/​s12602-017-9299-1 CrossRef
27.
Zurück zum Zitat Triplot N, Leber B, Blattl D (2012) Effect of supplementation with Lactobacillus casei Shirota on insulin sensitivity, b-cell function, and markers of endothelial function and inflammation in subjects with the metabolic syndrome—a pilot study. J Dairy Sci 96:89–95CrossRef Triplot N, Leber B, Blattl D (2012) Effect of supplementation with Lactobacillus casei Shirota on insulin sensitivity, b-cell function, and markers of endothelial function and inflammation in subjects with the metabolic syndrome—a pilot study. J Dairy Sci 96:89–95CrossRef
28.
Zurück zum Zitat Barazzoni R, Deutz N, Biolo G, Bischoff S, Boirie Y, Cederholm T et al (2017) Carbohydrates and insulin resistance in clinical nutrition: recommendations from the ESPEN expert group. Clin Nutr 36(2):355–363CrossRefPubMed Barazzoni R, Deutz N, Biolo G, Bischoff S, Boirie Y, Cederholm T et al (2017) Carbohydrates and insulin resistance in clinical nutrition: recommendations from the ESPEN expert group. Clin Nutr 36(2):355–363CrossRefPubMed
29.
Zurück zum Zitat Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D et al (2007) Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 56(7):1761–1772CrossRefPubMed Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D et al (2007) Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 56(7):1761–1772CrossRefPubMed
30.
Zurück zum Zitat Allin KH, Nielsen T, Pedersen O (2015) Mechanisms in endocrinology: gut microbiota in patients with type 2 diabetes mellitus. Eur J Endocrinol 172(4):R167–R177CrossRefPubMed Allin KH, Nielsen T, Pedersen O (2015) Mechanisms in endocrinology: gut microbiota in patients with type 2 diabetes mellitus. Eur J Endocrinol 172(4):R167–R177CrossRefPubMed
31.
Zurück zum Zitat Cani PD, Bibiloni R, Knauf C, Waget A, Neyrinck AM, Delzenne NM et al (2008) Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes 57(6):1470–1481CrossRefPubMed Cani PD, Bibiloni R, Knauf C, Waget A, Neyrinck AM, Delzenne NM et al (2008) Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes 57(6):1470–1481CrossRefPubMed
32.
Zurück zum Zitat Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O et al(2009) Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut 58(8):1091–1103CrossRefPubMed Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O et al(2009) Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut 58(8):1091–1103CrossRefPubMed
33.
Zurück zum Zitat Gao Z, Yin J, Zhang J, Ward RE, Martin RJ, Lefevre M et al (2009) Butyrate improves insulin sensitivity and increases energy expenditure in mice. Diabetes 58(7):1509–1517CrossRefPubMedPubMedCentral Gao Z, Yin J, Zhang J, Ward RE, Martin RJ, Lefevre M et al (2009) Butyrate improves insulin sensitivity and increases energy expenditure in mice. Diabetes 58(7):1509–1517CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Lin HV, Frassetto A, Kowalik EJ Jr, Nawrocki AR, Lu MM, Kosinski JR et al (2012) Butyrate and propionate protect against diet-induced obesity and regulate gut hormones via free fatty acid receptor 3-independent mechanisms. PloS One 7(4):e35240CrossRefPubMedPubMedCentral Lin HV, Frassetto A, Kowalik EJ Jr, Nawrocki AR, Lu MM, Kosinski JR et al (2012) Butyrate and propionate protect against diet-induced obesity and regulate gut hormones via free fatty acid receptor 3-independent mechanisms. PloS One 7(4):e35240CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Wichmann A, Allahyar A, Greiner TU, Plovier H, Lundén G, Larsson T et al (2013) Microbial modulation of energy availability in the colon regulates intestinal transit. Cell Host Microbe 14(5):582–590CrossRefPubMed Wichmann A, Allahyar A, Greiner TU, Plovier H, Lundén G, Larsson T et al (2013) Microbial modulation of energy availability in the colon regulates intestinal transit. Cell Host Microbe 14(5):582–590CrossRefPubMed
36.
Zurück zum Zitat Russo F, Riezzo G, Chiloiro M, De Michele G, Chimienti G, Marconi E et al (2010) Metabolic effects of a diet with inulin-enriched pasta in healthy young volunteers. Curr Pharm Des 16(7):825–831CrossRefPubMed Russo F, Riezzo G, Chiloiro M, De Michele G, Chimienti G, Marconi E et al (2010) Metabolic effects of a diet with inulin-enriched pasta in healthy young volunteers. Curr Pharm Des 16(7):825–831CrossRefPubMed
37.
Zurück zum Zitat Kim Y, Keogh J, Clifton P (2017) Probiotics, prebiotics, synbiotics and insulin sensitivity. Nutr Res Rev 17:1–17 Kim Y, Keogh J, Clifton P (2017) Probiotics, prebiotics, synbiotics and insulin sensitivity. Nutr Res Rev 17:1–17
38.
Zurück zum Zitat Tolhurst G, Heffron H, Lam YS, Parker HE, Habib AM, Diakogiannaki E et al (2012) Short-chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes 61(2):364–371CrossRefPubMedPubMedCentral Tolhurst G, Heffron H, Lam YS, Parker HE, Habib AM, Diakogiannaki E et al (2012) Short-chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes 61(2):364–371CrossRefPubMedPubMedCentral
Metadaten
Titel
The effects of probiotics and synbiotic supplementation on glucose and insulin metabolism in adults with prediabetes: a double-blind randomized clinical trial
verfasst von
Nazila Kassaian
Awat Feizi
Ashraf Aminorroaya
Parvaneh Jafari
Maryam Tajabadi Ebrahimi
Masoud Amini
Publikationsdatum
22.06.2018
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 10/2018
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-018-1175-2

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